Introduction: Research on the impact of physical activity (PA) and physical fitness on oral health has been limited in scope. The aim of this report was to assess the impact of PA and physical fitness as modifiable factors in dental caries and erosive tooth wear (ETW) among middle-aged individuals in Finland. Methods: Data were gathered from the North Finland Birth Cohort 1966 (NFBC1966) 46-year follow-up, which included dental clinical examinations conducted by seven calibrated dentists, physical fitness tests, measurements of PA, and measurements of height and weight administered between 2012 and 2014. PA was measured over a 2-week period with a wrist-worn accelerometer and reported as average daily duration of PA (min/day). Physical fitness was assessed by measuring cardiorespiratory fitness via heart rate recovery in a step test using a heart rate monitor and chest belt, and by evaluating back strength with the Biering-Sorensen test. Of the whole cohort, 1,964 cohort members participated in the oral clinical examination, and the regression models were conducted with 1,590 participants. The prevalence of dental caries (ICDAS), DMFT score, and ETW (BEWE), and the results of the PA test and physical fitness tests were categorized and analyzed using cross-tabulations and multivariable logistic regression models. SPSS version 29.0.0.0 was used to calculate 95% confidence intervals (CI), odds ratios (ORs), χ2, and p values. Results: Poor (OR 1.60, 95% CI: 1.15–2.23) and moderate (OR 1.48, 95% CI: 1.14–1.93) cardiorespiratory fitness and low PA (OR 1.48, 95% CI: 1.07–2.05) were associated with dentine caries in the regression model. The same model indicated that tooth brushing frequency (OR 1.97, 95% CI: 1.21–3.20), ETW (OR 1.30, 95% CI: 1.12–1.49), and male gender (OR 1.22, 95% CI: 1.05–1.43) were associated with increased dentine caries. No statistically significant association was found between PA or physical fitness and ETW. Conclusion: In the middle-aged Finnish population, high PA and good physical fitness are associated with a lower prevalence of dentine caries. No association between PA or physical fitness and ETW was found. Further research is needed to explore the potential oral health benefits of PA and physical fitness as modifiable factors.

Journal Section:
Research Article
Keywords:
Dental caries, Erosive tooth wear, Physical activity, Physical fitness
1.
Laajala
A
,
Karhatsu
P
,
Pesonen
P
,
Laitala
ML
,
Näpänkangas
R
,
Raustia
A
, et al.
Association of indirect restorations with past caries history and present need for restorative treatment in the Northern Finland Birth Cohort 1966
.
Clin Oral Investig
.
2018
;
22
(
3
):
1495
–
501
.
Google Scholar
PubMed
 
2.
National Institute of dental and craniofacial research (NIDCR)
[Internet]. Tooth Decay [cited 2024 Apr 21]. Available from: https://www.nidcr.nih.gov/health-info/tooth-decay
3.
Alaraudanjoki
V
,
Laitala
ML
,
Tjäderhane
L
,
Pesonen
P
,
Lussi
A
,
Anttonen
V
.
Association of erosive tooth wear and dental caries in Northern Finland Birth Cohort 1966 - an epidemiological cross-sectional study
.
BMC Oral Health
.
2016
;
17
(
1
):
6
.
Google Scholar
PubMed
 
4.
Carvalho
TS
,
Colon
P
,
Ganss
C
,
Huysmans
MC
,
Lussi
A
,
Schlueter
N
, et al.
Consensus report of the European federation of conservative dentistry: erosive tooth wear diagnosis and management
.
Swiss Dent J
.
2016
;
126
(
4
):
342
–
6
.
Google Scholar
PubMed
 
5.
Warburton
DE
,
Nicol
CW
,
Bredin
SS
.
Health benefits of physical activity: the evidence
.
CMAJ
.
2006
;
174
(
6
):
801
–
9
.
Google Scholar
PubMed
 
6.
Ashley
P
,
Di Iorio
A
,
Cole
E
,
Tanday
A
,
Needleman
I
.
Oral health of elite athletes and association with performance: a systematic review
.
Br J Sports Med
.
2015
;
49
(
1
):
14
–
9
.
Google Scholar
PubMed
 
7.
Needleman
I
,
Ashley
P
,
Fine
P
,
Haddad
F
,
Loosemore
M
,
de Medici
A
, et al.
Oral health and elite sport performance
.
Br J Sports Med
.
2015
;
49
(
1
):
3
–
6
.
Google Scholar
PubMed
 
8.
Frese
C
,
Frese
F
,
Kuhlmann
S
,
Saure
D
,
Reljic
D
,
Staehle
HJ
, et al.
Effect of endurance training on dental erosion, caries, and saliva
.
Scand J Med Sci Sports
.
2015
;
25
(
3
):
e319
–
26
.
Google Scholar
PubMed
 
9.
Khan
K
,
Qadir
A
,
Trakman
G
,
Aziz
T
,
Khattak
MI
,
Nabi
G
, et al.
Sports and energy drink consumption, oral health problems and performance impact among elite athletes
.
J Nutr
.
2022
;
14
(
23
):
5089
.
Google Scholar
 
10.
Huttunen
M
,
Kämppi
A
,
Soudunsaari
A
,
Päkkilä
J
,
Tjäderhane
L
,
Laitala
ML
, et al.
The association between dental caries and physical activity, physical fitness, and background factors among Finnish male conscripts
.
Odontology
.
2023
;
111
(
1
):
192
–
200
.
Google Scholar
PubMed
 
11.
Popa
PȘ
,
Onișor
D
,
Nechita
A
,
Earar
K
,
Matei
MN
.
Study on the influence of regular physical activity on children’s oral health
.
Children
.
2023
;
10
(
6
):
946
.
Google Scholar
PubMed
 
12.
Bramantoro
T
,
Hariyani
N
,
Setyowati
D
,
Purwanto
B
,
Zulfiana
AA
,
Irmalia
WR
.
The impact of oral health on physical fitness: a systematic review
.
Heliyon
.
2020
;
6
(
4
):
e03774
.
Google Scholar
PubMed
 
13.
Nijakowski
K
,
Zdrojewski
J
,
Nowak
M
,
Podgórski
F
,
Surdacka
A
.
Regular physical activity and dental erosion: a systematic review
.
Appl Sci
.
2022
;
12
(
3
):
1099
.
Google Scholar
 
14.
Tripodi
D
,
Cosi
A
,
Fulco
D
,
D’Ercole
S
.
The impact of sport training on oral health in athletes
.
Dent J
.
2021
;
9
(
5
):
51
.
Google Scholar
 
15.
Drummond
LR
,
Campos
HO
,
Drummond
FR
,
de Oliveira
GM
,
Fernandes
JGRP
,
Amorim
RP
, et al.
Acute and chronic effects of physical exercise on IgA and IgG levels and susceptibility to upper respiratory tract infections: a systematic review and meta-analysis
.
Pflugers Arch
.
2022
;
474
(
12
):
1221
–
48
.
Google Scholar
PubMed
 
16.
Ligtenberg
AJ
,
Brand
HS
,
van den Keijbus
PA
,
Veerman
EC
.
The effect of physical exercise on salivary secretion of MUC5B, amylase and lysozyme
.
Arch Oral Biol
.
2015
;
60
(
11
):
1639
–
44
.
Google Scholar
PubMed
 
17.
Nieman
DC
,
Wentz
LM
.
The compelling link between physical activity and the body's defense system
.
J Sport Health Sci
.
2019
;
8
(
3
):
201
–
17
.
Google Scholar
PubMed
 
18.
Akimoto
T
,
Kumai
Y
,
Akama
T
,
Hayashi
E
,
Murakami
H
,
Soma
R
, et al.
Effects of 12 months of exercise training on salivary secretory IgA levels in elderly subjects
.
Br J Sports Med
.
2003
;
37
(
1
):
76
–
9
.
Google Scholar
PubMed
 
19.
Virtanen
JI
,
Muikku
T
,
Similä
T
,
Cinar
AB
,
Pohjola
V
.
Physical activity, BMI and oral health behaviour among adolescents: Finnish School Health Promotion Study
.
Eur J Public Health
.
2019
;
29
(
2
):
296
–
302
.
Google Scholar
PubMed
 
20.
University of Oulu [Internet]
.
Northern Finland Birth cohorts and arctic biobank
. [cited 2024 Apr 21]. Available from: http://www.oulu.fi/nfbc/
21.
Nordström
T
,
Miettunen
J
,
Auvinen
J
,
Ala-Mursula
L
,
Keinänen-Kiukaanniemi
S
,
Veijola
J
, et al.
Cohort profile: 46 years of follow-up of the northern Finland Birth cohort 1966 (NFBC1966)
.
Int J Epidemiol
.
2022
;
50
(
6
):
1786
–
7j
.
Google Scholar
PubMed
 
22.
Ismail
AI
,
Sohn
W
,
Tellez
M
,
Amaya
A
,
Sen
A
,
Hasson
H
, et al.
The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries
.
Community Dent Oral Epidemiol
.
2007
;
35
(
3
):
170
–
8
.
Google Scholar
PubMed
 
23.
Bartlett
D
,
Ganss
C
,
Lussi
A
.
Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs
.
Clin Oral Investig
.
2008
;
12
(
Suppl 1
):
S65
–
8
.
Google Scholar
PubMed
 
24.
Shaw
J
,
Jacobs
JV
,
Van Dillen
LR
,
Beneck
GJ
,
Smith
JA
.
Understanding the Biering-Sørensen test: contributors to extensor endurance in young adults with and without a history of low back pain
.
J Electromyogr Kinesiol
.
2024
;
74
:
102854
.
Google Scholar
PubMed
 
25.
Niemelä
MS
,
Kangas
M
,
Ahola
RJ
,
Auvinen
JP
,
Leinonen
AM
,
Tammelin
TH
, et al.
Dose-response relation of self-reported and accelerometer-measured physical activity to perceived health in middle age-the Northern Finland Birth Cohort 1966 Study
.
BMC Public Health
.
2019
;
19
(
1
):
21
.
Google Scholar
PubMed
 
26.
Jetté
M
,
Sidney
K
,
Blümchen
G
.
Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity
.
Clin Cardiol
.
1990
;
13
(
8
):
555
–
65
.
Google Scholar
PubMed
 
27.
Leinonen
AM
,
Ahola
R
,
Kulmala
J
,
Hakonen
H
,
Vähä-Ypyä
H
,
Herzig
KH
, et al.
Measuring physical activity in free-living conditions-comparison of three accelerometry-based methods
.
Front Physiol
.
2016
;
7
:
681
.
Google Scholar
PubMed
 
28.
Pelttari
H
.
Painoindeksi (BMI) [internet]. Lääkärikirja duodecim. Helsinki: kustannus Oy duodecim
.
2024
. [cited 2024 Aug 17]. Available from: https://www.terveyskirjasto.fi/dlk01001
Google Scholar
 
29.
Gallagher
J
,
Ashley
P
,
Petrie
A
,
Needleman
I
.
Oral health-related behaviours reported by elite and professional athletes
.
Br Dent J
.
2019
;
227
(
4
):
276
–
80
.
Google Scholar
PubMed
 
30.
Ntovas
P
,
Loumprinis
N
,
Maniatakos
P
,
Margaritidi
L
,
Rahiotis
C
.
The effects of physical exercise on saliva composition: a Comprehensive Review
.
Dent J
.
2022
;
10
(
1
):
7
.
Google Scholar
 
31.
Suominen
AL
,
Varsio
S
,
Helminen
S
,
Nordblad
A
,
Lahti
S
,
Knuuttila
M
.
Dental and periodontal health in Finnish adults in 2000 and 2011
.
Acta Odontol Scand
.
2018
;
76
(
5
):
305
–
13
.
Google Scholar
PubMed
 
32.
Lipsky
MS
,
Su
S
,
Crespo
CJ
,
Hung
M
.
Men and oral health: a review of sex and gender differences
.
Am J Mens Health
.
2021
;
15
(
3
):
15579883211016361
.
Google Scholar
PubMed
 
33.
Kinnunen
H
,
Tanskanen
M
,
Kyröläinen
H
,
Westerterp
KR
.
Wrist-worn accelerometers in assessment of energy expenditure during intensive training
.
Physiol Meas
.
2012
;
33
(
11
):
1841
–
54
.
Google Scholar
PubMed
 
34.
Kinnunen
H
,
Häkkinen
K
,
Schumann
M
,
Karavirta
L
,
Westerterp
KR
,
Kyröläinen
H
.
Training-induced changes in daily energy expenditure: methodological evaluation using wrist-worn accelerometer, heart rate monitor, and doubly labeled water technique
.
PLoS One
.
2019
;
14
(
7
):
e0219563
.
Google Scholar
PubMed
 
35.
Römer
C
,
Wolfarth
B
.
Heart Rate Recovery (HRR) is not a singular predictor for physical fitness
.
Int J Environ Res Public Health
.
2022
;
20
(
1
):
792
.
Google Scholar
PubMed
 
36.
Huikari
S
,
Junttila
H
,
Ala-Mursula
L
,
Jämsä
T
,
Korpelainen
R
,
Miettunen
J
, et al.
Leisure-time physical activity is associated with socio-economic status beyond income: cross-sectional survey of the Northern Finland Birth Cohort 1966 study
.
Econ Hum Biol
.
2021
;
41
:
100969
.
Google Scholar
PubMed
 
37.
Niemelä
M
,
Kiviniemi
A
,
Kangas
M
,
Farrahi
V
,
Leinonen
AM
,
Ahola
R
, et al.
Prolonged bouts of sedentary time and cardiac autonomic function in midlife
.
Transl Sports Med
.
2019
;
2
(
6
):
341
–
50
.
Google Scholar
 
© 2025 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2025
You do not currently have access to this content.